The Search for Sleep

Posted at: 04/29/2013 11:35 AM
Updated at: 04/29/2013 10:30 PM
By: Brittany Falkers

When you say good morning to the world at 5 a.m., such as Good Morning Northland Anchor Brittany Falkers, you have a pretty unique schedule.  So, when it's time to sleep, you don't want any problems.

Almost half of Americans say they experience occasional insomnia, according to the National Sleep Foundation.  For some, that may just mean a groggy morning, but for others it can have a big effect on their overall health.

"Insomnia can certainly mean other problems besides just poor sleep," Dr. Vance Bachelder, medical director of St. Luke's Sleep Center, said.

Brittany says she's never had trouble sleeping before, but curious about the issues surrounding sleep, she headed to the Sleep Center at St. Luke's for a sleep study. It's a way for doctors to see if health issues you have during the day could be tied to what's happening at night.

The study starts with a few common health questions before sleep technician, Tom Kelleher, hooks the patients, in this case Brittany, up to a series of wires.  These wires rely on three main data collectors.

The first records electrical brain activity with an electroencephalograph or EEG.  This sends brain wave information back to a computer to be analyzed by Dr. Bachelder.  This focuses on specific areas of the brain for analyzing.

"F is frontal, C is central and O is occipital," Bachelder said, "So, we're looking at front central and back part of the brain."

Another device measures all those twitches your body makes during the night.  The electromyography or EMG is a technique to recording electrical activity in muscles.  This is a good way for Dr. Bachelder to evaluate movement when you're asleep. 

"These are down here on the shins and it's looking at electronic muscle tracings as well," he said.  Bachelder says too much movement can effect how rested you feel in the morning. 
"Sometimes, if you have enough of those [limb movement] people can have daytime sleepiness.  We call that periodic limb movement syndrome," Bachelder said. 

Measuring breathing is also a crucial part of the study because many people come to the sleep center concerned about breathing issues during the night. This data is collected using a nose piece pressure sensor.  A strap across the chest called an impedance monitor can tell if you are trying to take a breath.

"These belts are expanding and contracting because you're trying to breath," Kelleher said during the sleep study.  The two work together to show when an attempt to take a breath is successful and when someone is trying to take a breath, but cannot.  This pause in breathing during sleep is called sleep apnea, the most common problem Dr. Bachelder sees patients for.

Usually sleep patients stay overnight.  That way doctors can get a full range of sleep over an eight hour period or longer.  However, for Brittany, she opted for a long three hour nap.  Then, it's time to get up.

Bachelder looks over all the data generated by the many wires and recording devices attached to the body.  Each helps to show where Brittany is in the stages of sleep, which helps Bachelder find any abnormalities.

"So, here's what's been scored as stage one," Bachelder says while pointing at the brain wave tracings on a monitor.

The proof?  The brain waves are quick when Brittany is awake.  However, they slow down when she drifts off. Then, as the waves start to look like spindles, she has entered stage two.

"That's typically where most people sleep," Bachelder said, "You spend about 50 percent of the night in stage two."

After that, it's on to stage three or slow-wave sleep.  Then, finally she hits the deepest stage of sleep: REM, or rapid eye movement, sleep.

"It's thought that most of the time, people will have fairly significant, vivid, and fairly scary dreams.  Most of the time, people are amnestic, they don't remember their dreams," Bachelder said.

But, if those REM sleep dreams can be so intense, why doesn't our body move around in a big way?

"That's because your brain, in order to keep you from dream-enacting, or jumping out of windows or whatever it is, your brain will paralyze your body," he said. 

However, that paralyzing safety effect does not happen for everyone.  That is called a REM behavior disorder, but that doesn't mean every aspect of a dream will be acted out in bed.

"If you have REM behavior disorder, typically you will have enacting behavior, it will tend to be more rudimentary," Bachelder said, "They might end up punching a hole in the wall or their bed partner might get punched or something.  Sometimes they'll accidentally throw themselves out of bed." 

Bachelder says there's a big reason you should try to reach REM sleep.  He says it can have improve memory, problem solving, and even motor skills.  For example, if you are learning to play the piano there are certain stage of sleep that ten to make one more able to do that efficiently, according to Bachelder.

"So, if your somebody who has practiced a lot, you go to sleep.  The next day it's not uncommon that you feel like you can play a little bit better," he said.

Sleep studies can shed light on everything from insomnia, to daytime sleepiness to other health problems.  For Brittany, it was good news. Bachelder says her only issues are occasional leg movements and some shallow breathing, but he gave her the all clear.

These sleep studies are much more than an interesting look at the sleeping mind.  It is a chance for people with real health issues to get to the root of their sleeping problems.

For more information on the Sleep Center at St. Luke's CLICK HERE.

For more general information on sleep check out the National Sleep Foundation.